Puncture type nail supporting base and anastomatTechnical field
The present invention relates to medical instruments field, be in particular a kind of puncture type nail supporting base and anastomat.
Background technology
Medical stapler is a kind of a kind of medical apparatus and instruments often used when organizing and implementing surgical operation to digestion living according to principles for self-cultivation reason.
Anastomat is usually divided into disposable or repeatedly uses two classes.The using method of existing anastomat is: first anastomotic stoma near-end intestinal is put purse string suture, then insert nail supporting base and tighten up, anastomat is inserted by far-end, and pass anastomat center perforator, be connected with near-end stapling device nail supporting base center-pole, rotate near far and near end intestinal tube intestinal wall, according to the distance of intestinal wall thickness adjustment resist-nailed seat of anastomat and base, be generally 1.5 ~ 2.5cm or hand-screw and turn tightlier to be limited and open insurance; Finally press percussion lock docking site is cut off and fastens titanium nail by two intestinal segments joints.
It should be noted that: above alleged purse string suture is sewed up also known as bag mouth: as the frenulum around tobacco pouch.Method does to sew up continuously around opening part, while tissue or stump inwardly being ploughed under from pocket, and the knotting of tension suture.This operation at least needs two medical workers, and a people is responsible for fixing suture site with operating forceps, and another person carries out sew application;
And insert this operation of nail supporting base, present operating standing procedure uses three operating forcepies to clamp stoma site from three different directions respectively to be strutted, by a wherein people, nail supporting base is inserted wherein again, finally pocket mouth is closed, in the middle of this operating process, that is need three medical workers to coordinate tacitly just can complete.
Above-mentioned two actions are the necessary operating procedures of existing all anastomats, therefrom be not difficult to find out that anastomat and the nail supporting base structure of existing this structure are reasonable not enough, make medical worker's complicated operation in the middle of the process used and need multi-person synergy to coordinate just can complete.
And what is more important: present operation is progressively to the future development of Wicresoft, the operation mouth of Minimally Invasive Surgery and working place are all very narrow and small, therefore more difficult when carrying out above-mentioned two operational motions, under the mirror of full chamber, medical worker has even been difficult to above-mentioned operating procedure.
Therefore, invention one is simple to operate, action required personnel are few, can meet in Minimally Invasive Surgery for the nail supporting base of operative space demand and anastomat.
Summary of the invention
The object of the invention is to: provide a kind of puncture type nail supporting base and anastomat, it is easy to use, single gets final product complete operation, can meet Minimally Invasive Surgery simple for the requirement of working place, structure.
The present invention's technical scheme is as follows:
A kind of puncture type nail supporting base, is characterized in that: comprise core bar, be set in core bar outer and can relatively core bar move forward and backward loop bar, be installed in core bar leading section and also reveal the puncture awl put in loop bar outside and the folding fixed part be arranged between puncture awl and loop bar;
Described folding fixed part is made up of the folding unit that at least three are looped around core bar surrounding, each folding unit comprise to nail-plate and with the gripper shoe of supporting the front end of nail-plate and being rotationally connected, be rotationally connected to the rear end of nail-plate and loop bar, front end and the puncture awl of gripper shoe are rotationally connected;
The described outer surface respectively supporting nail-plate is provided with nail groove.
Its work process and principle as follows:
Early-stage preparations step: as shown in Figures 1 and 3, keeps gripper shoe, is laid on core bar periphery wall to nail-plate, make gripper shoe, jointly form a rod-like structure to nail-plate, loop bar and core bar to facilitate the puncture procedure of puncture type nail supporting base before using;
Step 1: sew up, first utilize straight cuts closer to carry out sewing up and blocking intestinal anastomotic stoma near-end intestinal;
Step 2: as shown in Figure 7, puncture, is inserted puncture type nail supporting base by the far-end of anastomotic stoma and the near-end intestinal inside entering anastomotic stoma of puncturing;
Step 3: as shown in Fig. 2, Fig. 4 and Fig. 8, fixing, gently loop bar is pushed forward to limit convex along place, make outwards to launch to nail-plate and coordinate with gripper shoe puncture type nail supporting base is fixed in the near-end intestinal inside of anastomotic stoma;
Step 4: as shown in Figure 5, coincide, the base on adjusting fitting device, itself and the axial distance supported between nail-plate is shortened gradually until to adapt position with intestinal wall thickness, finally presses percussion lock and complete coincideing of intestinal.
In order to better implement the technical program, additionally provide following prioritization scheme:
Further, described core bar periphery wall pressed on ring between puncture awl and loop bar is arranged with and can limits loop bar moves forward extreme position limit convex edge relative to core bar.
Convex edge is can be vertical with core bar radial direction with the nail-plate that supports following closely groove after nail-plate better launches and finally ensures expansion in order to allow.
Further, described gripper shoe is slightly longer than to nail-plate.
This is to allow when nail-plate opens and gripper shoe forms leg-of-mutton rock-steady structure jointly, greatly strengthens and supports nail-plate intensity operationally, makes when identical, support the intensity that nail-plate can meet stitching.
As shown in Figure 5, further, described each nail groove quantity of supporting on nail-plate outer surface is two and mutually stagger and to make when folding fixed part expansion two to follow closely grooves to be neither positioned at same circumferential position and not also to be positioned in same radial position in the position of two nail grooves.
Be in order to when stitching like this, form inside and outside two stitching circles at anastomotic stoma place, what anastomotic stoma was sealed is tighter.
As shown in Figure 6, in order to better nail and anastomotic stoma, secondary can be adopted to pull the trigger stitching, and namely first stitching once, there is the problem in gap when then puncture type nail supporting base to be rotated certain angle stitching makes up stitching first again between titanium nail.
Further, the rear end face of described puncture awl and the cross section of core bar are the limit number polygon consistent with the quantity of supporting nail-plate.
The rear end face of the above puncture awl and the shape of cross section of core bar are preferably regular polygon.
Another technical scheme of the present invention is as follows:
A kind of anastomat of puncture type nail supporting base, comprise nail supporting base, nail kit assembly, percussion lock and device body, described nail kit assembly is arranged on described device body front end, described percussion lock is arranged on described device and pulls the trigger forward for staple in control nail cartridge component side after one's death, described nail supporting base is arranged at position corresponding with nail kit assembly on front side of described device body front end, it is characterized in that: described nail supporting base comprises core bar, be set in the outer also energy of the core bar loop bar that core bar is movable relatively, be installed in core bar leading section and also reveal the puncture awl put in loop bar outside and the folding fixed part be arranged between puncture awl and loop bar, described folding fixed part is made up of the folding unit that at least three are looped around core bar surrounding, each folding unit comprise to nail-plate and with the gripper shoe of supporting the front end of nail-plate and being rotationally connected, be rotationally connected to the rear end of nail-plate and loop bar, front end and the puncture awl of gripper shoe are rotationally connected, the described outer surface respectively supporting nail-plate is provided with nail groove,
Described core bar to be placed through in device health and can to move forward and backward relative to nail kit assembly; Also be provided with it for controlling the first controlling organization that core bar moves forward and backward relative to nail kit assembly and for controlling loop bar second controlling organization movable relative to nail kit assembly at described device.
Here, anastomat separately can control the movement of core bar and loop bar with fixing, and can complete secondary percussion.First controlling organization can control core bar and complete and to be independently elevated and fixing in order to coordinate loop bar to be opened folding part.Second controlling organization can control loop bar and complete and to be independently elevated and fixing in order to coordinate core bar to be opened folding part.
Simultaneously the first controlling organization and the second controlling organization can be arranged on the afterbody of percussion lock, and the part configuration of above-described nail kit assembly, percussion lock and device body and inside thereof all can adopt existing design of part.In order to better implement the technical program, additionally provide following prioritization scheme:
Further, described core bar periphery wall pressed on ring between puncture awl and loop bar is arranged with and can limits loop bar moves forward extreme position limit convex edge relative to core bar.
Further, described gripper shoe is slightly longer than to nail-plate.
Further, described each nail groove quantity of supporting on nail-plate outer surface is two and mutually stagger and to make when folding fixed part expansion two to follow closely grooves to be neither positioned at same circumferential position and not also to be positioned in same radial position in the position of two nail grooves.
Further, the rear end face of described puncture awl and the cross section of core bar are the limit number polygon consistent with the quantity of supporting nail-plate.
Technology comparatively, beneficial effect of the present invention is:
1, after adopting nail supporting base of the present invention, without the need to carrying out purse string suture to the digestive tract physiological tissue for docking, but employing only needs the single straight cuts closer getting final product complete operation to sew up, after this only nail supporting base need be entered from the position Direct perforantes sewed up and complete fixing, carry out inserting this operation of nail supporting base without the need to many people, therefore whole process operation simply, only need single just can complete all operations, to working place require low, the demand of Minimally Invasive Surgery can be met;
2, the present invention changes previously anastomat completely and adopts nail supporting base and perforator two assemblies to be connected respectively to coordinate and realize the identical mode of digestive tract physiological tissue; Creationaryly eliminate this requisite assembly of perforator, directly controlled by anastomat that nail supporting base completes the overall process of digestive tract physiological tissue docking, structure is simple.
Accompanying drawing explanation
Fig. 1 is schematic perspective view under the non-deployed condition of puncture type nail supporting base;
Fig. 2 is schematic perspective view under puncture type nail supporting base deployed condition;
Fig. 3 is puncture type nail supporting base non-deployed condition lower section schematic diagram;
Fig. 4 is puncture type nail supporting base deployed condition lower section schematic diagram;
Fig. 5 is upward view under puncture type nail supporting base deployed condition;
Fig. 6 is secondary percussion schematic diagram after puncture type nail supporting base rotates;
Working state schematic representation when Fig. 7 is the puncture of puncture type nail supporting base;
Fig. 8 is puncture type nail supporting base working state schematic representation when fixing;
Fig. 9 is anastomat schematic perspective view of the present invention.
Label declaration: 1 core bar, 1-1 support nail-plate, 1-11 follows closely groove, 1-2 gripper shoe, 1-3 limit convex edge, 2 puncture awls, 3 loop bars, 4-2 nail kit assembly, 4-3 percussion lock, 4-4 device body, 4-5 first controlling organization, 4-6 second controlling organization.
Detailed description of the invention
Illustrate below in conjunction with accompanying drawing and the present invention elaborated:
Embodiment 1:
The present embodiment is a kind of puncture type nail supporting base, it is characterized in that: comprise core bar 1, be set in core bar 1 outer and can core bar 1 is movable relatively loop bar 3, be installed in core bar 1 leading section and also reveal the puncture awl 2 put in loop bar 3 outside and the folding fixed part be arranged between puncture awl 2 and loop bar 3;
Described folding fixed part is made up of the folding unit that at least three are looped around core bar 1 surrounding, each folding unit comprise to nail-plate 1-1 and with the gripper shoe 1-2 supporting the front end of nail-plate 1-1 and be rotationally connected, be rotationally connected to the rear end of nail-plate 1-1 and loop bar 3, front end and the puncture awl 2 of gripper shoe 1-2 are rotationally connected;
The described outer surface respectively supporting nail-plate 1-1 is provided with nail groove 1-11.
Further, described core bar 1 periphery wall pressed on ring between puncture awl 2 and loop bar 3 is arranged with and can limits loop bar 3 and move forward the limit convex of extreme position along 1-3 relative to core bar 1.
Further, described gripper shoe 1-2 is slightly longer than to nail-plate 1-1.
Further, described each nail groove 1-11 quantity of supporting on nail-plate 1-1 outer surface is two and mutually stagger and to make when folding fixed part expansion two to follow closely groove 1-11 to be neither positioned at same circumferential position and not also to be positioned in same radial position in the position of two nail groove 1-11.
Further, the rear end face of described puncture awl 2 and the cross section of core bar 1 are the limit number polygon consistent with the quantity of supporting nail-plate 1-1.
Embodiment 2:
As shown in Figure 9, the present embodiment for a kind of with the anastomat of the puncture type nail supporting base described in embodiment 1, comprise nail supporting base, nail kit assembly 4-2, percussion lock 4-3 and device body 4-4, described nail kit assembly 4-2 is arranged on described device body 4-4 front end, described percussion lock 4-3 is arranged on rear side of described device body 4-4 and pulls the trigger forward for staple in control nail cartridge component 4-2, described nail supporting base is arranged at position corresponding with nail kit assembly 4-2 on front side of described device body 4-4 front end, it is characterized in that: described nail supporting base comprises core bar 1, be set in the outer also energy loop bar 3 that core bar 1 is movable relatively of core bar 1, be installed in core bar 1 leading section and also reveal the puncture awl 2 put in loop bar 3 outside and the folding fixed part be arranged between puncture awl 2 and loop bar 3, described folding fixed part is made up of the folding unit that at least three are looped around core bar 1 surrounding, each folding unit comprise to nail-plate 1-1 and with the gripper shoe 1-2 supporting the front end of nail-plate 1-1 and be rotationally connected, be rotationally connected to the rear end of nail-plate 1-1 and loop bar 3, front end and the puncture awl 2 of gripper shoe 1-2 are rotationally connected, the described outer surface respectively supporting nail-plate 1-1 is provided with nail groove 1-11,
Described core bar 1 to be placed through in device body 4-4 body and can to move forward and backward relative to nail kit assembly 4-2; Described device body 4-4 is also provided with for controlling the first controlling organization 4-5 that core bar 1 moves forward and backward relative to nail kit assembly 4-2 and for controlling the loop bar 3 second controlling organization 4-6 movable relative to nail kit assembly 4-2.
Further, described core bar 1 periphery wall pressed on ring between puncture awl 2 and loop bar 3 is arranged with and can limits loop bar 3 and move forward the limit convex of extreme position along 1-3 relative to core bar 1.
Further, described gripper shoe 1-2 is slightly longer than to nail-plate 1-1.
Further, described each nail groove 1-11 quantity of supporting on nail-plate 1-1 outer surface is two and mutually stagger and to make when folding fixed part expansion two to follow closely groove 1-11 to be neither positioned at same circumferential position and not also to be positioned in same radial position in the position of two nail groove 1-11.
Further, the rear end face of described puncture awl 2 and the cross section of core bar 1 are the limit number polygon consistent with the quantity of supporting nail-plate 1-1.
Although the present invention adopts specific embodiment and alternative thereof illustrate to the present invention and illustrate, only to should be appreciated that otherwise the variations and modifications deviated from scope of the present invention all can be implemented.Therefore, except being to be understood that the restriction of claim except being enclosed and condition of equivalent thereof, the present invention is not by the restriction of going up in all senses.